Chronic liver disease is one of the major chronic diseases in China, and slowing or even reversing its course is a significant challenge. The sympathetic nervous system has an important role in the development of chronic liver disease, which can be used as a target for the prevention and treatment of chronic liver disease. Sympathetic ablation is now being used to treat a wide range of diseases, and this has implications for the treatment of chronic liver disease. As an important ablation technology, the nanosecond knife, which relies on nanosecond pulsed electric fields to achieve ablation, has unique advantages and may be a potential treatment option for chronic liver disease. This paper reviewed the link between sympathetic excitation and chronic liver disease, the progress of ablation of sympathetic nerves for disease treatment, the application of pulsed electric fields in disease treatment, analyzed the feasibility of using pulsed electric fields in the prevention and treatment of chronic liver disease, and looked forward to and summarized the prospects for the application of pulsed electric fields in the treatment of chronic liver disease and the challenges it faces, aimed to provide a theoretical basis and reference for the treatment of chronic liver diseases with pulsed electric fields
Nanosecond pulsed electric field (nsPEF) is an emerging electroablation technology that induces tumor cell electroporation, calcium influx, and reactive oxygen species accumulation by applying a high-intensity electric field in an extremely short duration. This paper summarized the mechanisms of nsPEF in tumor ablation, particularly its specific effects at the cellular and molecular levels. Research indicated that nsPEF induced tumor cell death through various pathways, including intrinsic and extrinsic apoptosis, necrosis, autophagy, and immune response pathways, thereby enhancing anti-tumor immune reactions. Despite the potential of nsPEF in tumor treatment, its application faces challenges such as the need for further elucidation of its mechanisms, optimization of parameters, and improvement of treatment strategies. Future research should continue to explore the application of nsPEF in different types of tumors and integrate it with other treatment modalities to develop more comprehensive and personalized therapeutic approaches, thereby enhancing its clinical efficacy and safety
Objective To use nanosecond pulsed electric nield (nsPEF) for minimally invasive ablation of goat breast tissue, to explore the safety of pulsed electric field ablation for breast tissue. Methods Three adult normal female goats were selected. After local anesthesia, the ultrasound-guided transcutaneous ablation of breast tissue was performed with the electrode needle connected with the nanosecond pulsed tumor ablation system. Changes in vital signs of experimental goat during ablation were observed, blood biochemistry were detected before, after and during follow-up, ultrasound images of mammary ablation sites were collected, and pathological samples were taken to compare the pathological changes of mammary tissue before and after ablation. Results The nsPEF technique was successful in the ablation of breast tissue in goats. No adverse reaction occurred during the operation and no muscle tremors or contractions were observed around the breast during ablation. Ultrasound examination found that the ablation effect was significant during the regular follow-up after the operation. There was no significant difference in blood examination before and after operation. The histopathology showed apoptosis and necrosis in the ablated region, and normal tissue morphology in the non-ablated region. Conclusion nsPEF technique is effective and safe for breast ablation in goats, and the minimally invasive ablation operation on large preclinical animals is feasible
Wound healing is a complex and dynamic physiological process involving multiple stages of biological responses, including hemostasis, inflammation, proliferation, and remodeling. In recent years, nanosecond pulsed electric field (nsPEF) has garnered significant attention for their potential in cellular and tissue repair, demonstrating promising applications in promoting wound healing. This review systematically summarized the fundamental principles of nsPEF and its mechanisms of influence during the wound healing process, exploring its effects on cell proliferation, migration, angiogenesis, and anti-inflammatory and antibacterial actions, as well as its ability to enhance the uptake of drugs and nutrients through electroporation. Although nsPEF is still in the exploratory stage of clinical application, preliminary results from animal models and clinical trials have shown that it can significantly accelerate the healing of acute and chronic wounds while reducing infection rates. However, further research is needed to address questions regarding the effects of different intensities, frequencies, and durations of electric field exposure on treatment outcomes, as well as the applicability to various wound types and long-term safety. Future studies should focus on optimizing the parameters of nsPEF use and combining it with other treatment methods to achieve personalized treatment plans, thereby improving overall efficacy and safety
Cutaneous scar is an outcome of the physiological wound healing process. Pathological scar, including hypertrophic scars
and keloids, arises from the abnormal activity of fibroblasts and excessive accumulation of extracellular matrix. The formation of
pathological scars involves a multitude of cell types and intricate molecular signaling pathways. Current therapeutic approaches
encompass local steroid injections, radiotherapy, external treatments, laser therapy, cryotherapy, and surgery, yet they exhibit limited
efficacy. Nanosecond pulsed electric field (nsPEF) technology, an emerging non-thermal bioelectric treatment modality, activates
programmed cell death through ultra-short pulsed electrical energy, exhibiting selectivity for the treatment area with minimal damage
to surrounding tissues. nsPEF has demonstrated safety and efficacy in the treatment of cutaneous malignancies and benign lesions.
In the context of scar treatment, nsPEF theoretically could induce programmed cell death in fibroblasts, softening the extracellular
matrix, thereby providing a novel perspective for improving tissue healing and reducing scarring. Additionally, nsPEF may mitigate
scar formation through anti-angiogenic, immunomodulatory effects, and modulation of relevant signaling pathways. However,
the specific effects and mechanisms warrant further investigation. Future research will focus on the therapeutic efficacy, protocol
optimization, and determination of treatment parameters of nsPEF technology to validate its clinical application value in the treatment
of pathological scar.
Objective To model and simulate the dynamics of minimally invasive surgical robot driven by rope, aiming at the problem that it is difficult to obtain the dynamic model when the end instruments of minimally invasive surgical robot enter the human body and transfer the power of the motor by wire rope. Methods The rope-wheel driving system of rope-driven structure of the hand-held minimally invasive surgical robot was analyzed first, and the relationship between the driving wheel torque and the driven wheel torque was obtained. Then, the end-joint structure of the minimally invasive surgical robot was simplified and the dynamic model was built. Aiming at the complete dynamic model of the rope-driven minimally invasive surgical robot, ADAMS was used to simulate the rope-driven minimally invasive surgical robot and test the gripping force. Results The simulation Results showed that the theoretical driving torque was basically same as the simulated driving torque. In the gripping force test experiment, the estimated value was compared with the actual measured value, and the maximum error of the model was 0.265 N (1.5%), indicating that this model had obvious advantages in improving the accuracy. Conclusion This model solves the modeling difficulties caused by the special properties of the rope in rope-driven surgical robots, and provides a theoretical basis for the perception of gripping force of the master-slave integrated hand-held surgical robots
Objective To solve the problem of water leakage and gas leakage during the use of dental treatment unit, to design a monitoring and regulation system for dental treatment unit based on the Internet of Things and WeChat mini program. Methods The leakage sensor was deployed in the dental treatment unit, and the monitoring and regulation module was deployed at the air compressor to monitor the internal liquid leakage of the equipment and the temperature, current, start and stop parameters of the air compressor motor, and realize the automatic switching of air compressor. The cloud platform stored data and displayed the data on the page. The WeChat mini program was used for the mobile terminal to query the status and send control commands for the whole period. Results By verifying the system, setting different leakage environment and simulating the abnormal condition of air compressor, the qualified rate of alarm triggering reached 100%. After the application of the system, data such as water leakage discovery-solution time, gas leakage discovery-solution time, air compressor startup frequency difference and inspection time were shorter than those before the application of the system, and the differences were statistically significant (P<0.05). At the same time, the average number of monthly repair reports decreased by 40.11%, indicating that the system had a significant role in assisting engineers in maintenance, inspection and fault warning. Conclusion The system can provide timely warning for the abnormal water and air routes of the dental treatment unit, provide data support for the post-fault analysis, ensure the orderly development of clinical diagnosis and treatment activities, and greatly reduce the time required for engineers to deal with faults, which has high practical value and popularization significance
Objective To explore the interaction between cerebral blood flow microcirculation, blood pressure and cerebral autoregulation. Methods Twenty healthy adult subjects were recruited to complete four experimental tasks: upright tilt task, thigh cuff compression task, active standing task and squatting task to induce simultaneous changes of capillary blood flow and blood pressure in the brain. Cerebral blood flow was measured by diffuse correlation spectroscopy, blood pressure was recorded in real time by fingertip blood pressure recording technology, and the data frequency was matched by integer algorithm to ensure the consistency of data processing. In addition, the dynamic changes of blood flow and blood pressure were evaluated quantitatively by setting reaction time, response change rate, integral. Results In the active standing task, blood pressure and blood flow showed significant positive correlation (r=0.65)，(P=0.036), but no significant correlation was found in other tasks. The speed of blood pressure adjustment in all tasks was faster than that of blood flow, the difference was statistically significant (P<0.05),and the difference of thigh cuff compression task was the most significant (t=8.926)，(P<0.001). Integral analysis showed a significant positive correlation between thigh cuff compression (r=0.55)，(P=0.016) and active standing task (=0.45)，(P=0.022). These findings suggested that the blood pressure regulation system had a faster response characteristic. Conclusion This study analyzes the relationship between blood pressure and cerebral blood flow through the multi-task paradigm, which can provide experimental basis for quantifying cerebral blood flow autoregulation and provide a priori reference for future quantitative research on cerebral blood flow autoregulation mechanism
Objective To analyze and compare the effect of multifunctional air disinfection machine and ultraviolet disinfection on air purification and disinfection in emergency rescue room, and to provide relevant reference for reducing nosocomial infection in emergency rescue room. Methods A total of 60 cases of fever diagnosis patients in the emergency rescue room of our hospital from January to December 2022 were selected as the study objects. According to different disinfection Methods, they were respectively assigned to the multifunctional air disinfection group (n=30) and the ultraviolet disinfection group (n=30). The concentrations of particulate matter [PM0.3 (particulate matter with diameter ≤0.3 μm in the air, and so on), PM0.5, PM1.0, PM3.0, PM5.0] in the air of the two groups were detected, and the air purification effect of the two groups was observed (the total number of bacterial colonies in the air 0, 15, 20 min after the patient entered the room). Results Before disinfection, there was no significant difference in PM0.3 - 1.0, PM1.0 - 3.0, PM1.0 - 5.0 and PM3.0 - 5.0 concentrations between the two groups (P>0.05). After disinfection, the PM0.3 - 1.0, PM1.0 - 3.0, PM1.0 - 5.0 and PM3.0 - 5.0 particulate concentrations of the multifunctional air disinfection group were lower than those of the ultraviolet disinfection group, the difference were statistically significant (P<0.05). Intra-group comparison showed that there were no significant differences in PM0.3 - 1.0, PM1.0 - 3.0, PM1.0 - 5.0 and PM3.0 - 5.0 particulate concentrations in the ultraviolet disinfection group before and after disinfection (P>0.05). The particulate concentrations of PM0.3 - 1.0, PM1.0 - 3.0, PM1.0 - 5.0 and PM3.0 - 5.0 after disinfection of multifunctional air disinfection group were lower than those before disinfection, and the differences were statistically significant (P<0.05). Comparison of total bacterial colonies: 15 and 20 min after disinfection, the total bacterial colonies of multifunctional air disinfection group were significantly lower than those of ultraviolet disinfection group, the difference was statistically significant (P<0.05). Comparison of disinfection rate: 15 and 20 min after patients entered the room, the disinfection rate of multifunctional air disinfection group was significantly higher than that of ultraviolet disinfection group, the difference was statistically significant (P<0.05). Conclusion The air purification and air disinfection effect of multifunctional air disinfection machine in emergency rescue room is better than that of ultraviolet disinfection, which is suitable for clinical application.
Objective To propose a multimodal ultrasound diagnosis method, which combines deep learning with multimodal ultrasound imaging technology, in order to further improve the application value of multimodal ultrasound imaging technology in the diagnosis of liver diseases, and achieve higher precision disease diagnosis. Methods: Firstly, the concept of edge perception was introduced, and a network framework for image segmentation was proposed. The image segmentation model was obtained by training, and the multi-modal ultrasound images were preprocessed. Then, support vector machine (SVM) was used as the base classifier, and multiple base classifiers were established by combining the characteristics of multimodal ultrasound images. Finally, the coefficients of the base classifiers were determined according to the information entropy, dispersion and mean-variance ratio, and the fused multimodal ultrasound diagnosis Results were obtained. Results: The research Results showed that the diagnostic accuracy of the multi-modal ultrasonic imaging diagnostic model combined with deep learning method reached 95.78%, the false positive rate and false negative rate were 4.23% and 4.50% respectively, F1 score reached 0.93, and Kappa statistic reached 0.92, with high diagnostic accuracy. Conclusion: The multimodal ultrasound diagnosis method proposed in this study has high application value in the diagnosis of liver diseases, which can help doctors to determine the disease status of patients
Objective To investigate the dosimetry effects of cone beam CT (CBCT) guided positioning error on the target area and organs at risk of intensity modulated radiation therapy (IMRT) in patients with lung cancer. Methods A total of 35 patients with lung cancer who underwent IMRT in Beijing Chest Hospital, Capital Medical University were selected as the study objects. And a total of 175 CBCT data were collected. The mean value of multiple positioning errors for each patient was calculated, and the mean value of positioning errors in X (left and right), Y (head and foot), and Z (lift and fall) directions were obtained. The mean value was reset to generate a simulated plan for the treatment center, and the obtained dosimetry data (including target areas and organs at risk) were compared with the original plan, to study the effect of positioning error on IMRT dose of lung cancer. Results The positioning errors in X, Y and Z directions were (-0.17±2.67), (0.80±3.39) and (-0.13±2.23) mm, respectively. Among them, the ratio of Y orientation error greater than 5 mm accounted for the highest proportion, up to 17%. Comparing the original plan with the simulated plan, the prescribed dose percentages corresponding to D98% (minimum dose received by 98% of the target volume, and so on), D95% and D2% of the planning target volume were 98.66%±0.52%, 100.29%±0.43% and 106.71%±0.71%, respectively. Compared with 89.84%±1.82%, 96.50%±1.06% and 107.33%±0.74% in the simulated plan, the differences were statistically significant (P<0.001). In the organs at risk, the spinal cord D1 cc (the maximum dose of the organ receiving 1 cc volume irradiation) and Dmax (the maximum dose) increased from the original planned dose, respectively, with statistical significance (P<0.05); and comparing the rest of the heart [V30 (percentage of the volume of organs receiving at least 30 Gy dose, and so on), V40, Dmean (average dose)], double lungs (V5, V20, Dmean), esophagus (V30, V50, Dmean), left anterior descending coronary artery and other organs at risk of the simulated plan target area metrological parameters with the original plan, there were no statistical significance (P>0.05). Conclusion CBCT can be used to measure the positioning error of IMRT in lung cancer. The positioning error can have dosimetry effect on the actual radiotherapy plan. In clinical practice, the error value measured by CBCT can be adjusted to reduce the positioning error and reduce the influence on the actual radiotherapy plan.
Objective To escape the traditional passive regulatory model of critical values, to build an intelligent management platform for hospital critical values based on knowledge base, so as to improve the management efficiency of critical values and reduce medical risks. Methods The platform was developed using the C# language, with deployment achieved through C/S architecture and Oracle 11g database. The Web Service interface and message platform were used to for encrypted transmission in the data interaction between systems. The data before the platform was launched (from January to June 2023) and after the platform was launched (from January to June 2024) were selected as the control group and the experimental group, respectively. And the critical values data were compared and analyzed to verify the application effect of the platform. Results The critical values reporting time, false-positive rate, clinical response time and missing rate of critical value in electronic medical records of the experimental group were lower than those of the control group (P<0.05), and the clinical disposal rate and timely reporting rate of the experimental group were significantly higher than those of the control group (P<0.05). Conclusion The intelligent management platform for hospital critical values based on knowledge base achieves unified management of the entire process of critical values, significantly improves the management indicators of critical values, and provides safer and more efficient medical security for patients’ diagnosis and treatment.
Objective To realize the unified management of personal digital certificates under the multi-system integration architecture of hospital, to improve the efficiency and accuracy of digital certificate authorization for users of multiple business systems in hospital. Methods The OA process and the integrated platform master data management system were used to realize the standardized application and unified authorization of digital certificates, and the hospital digital certificate management system was built to realize the unified authorization and minimum authorization of digital certificates under the multi-system integration architecture. Results The certificate binding time after application of the platform authorization was 74.02[57.45, 89.32] s, which was significantly lower than that of the single business system authorization 318.58[298.76, 337.65] s, and the difference was statistically significant (P<0.001) Conclusion The unified authorization of digital certificates achieved through the master data management of the hospital integration platform can significantly improve work efficiency and reduce the error rate, which is worthy of promotion and reference.
Objective To establish a one-stop service management platform for medical equipment, integrate hospital system resources by means of information technology, improve support capabilities and service awareness, and provide data support for decision-making. Methods Based on the PC terminal and WeChat applet as the medium, the fixed asset system, equipment maintenance operation system and other hospital systems were connected, and the one-stop service dispatching center was established to standardize the repair and maintenance process of medical equipment, so as to realize the standardized and high-quality management of medical equipment. Results After the launch of the one-stop service management platform, the response time, maintenance time and parts application time of equipment maintenance were significantly lower than those before the launch of the platform, and the differences were statistically significant (P<0.05). The clinical satisfaction was improved compared with that before the platform was launched, and the difference was statistically significant (P<0.05). Conclusion The one-stop service management platform provides an advanced comprehensive medical equipment management mode, which can realize the closed-loop management of the whole life cycle of medical equipment from admission to scrapping, and it is worthy of promotion and reference.
Objective To design an online acceptance system for medical equipment, to improve the quality of acceptance materials and the efficiency of acceptance work for medical equipment. Methods The front-end of system was developed on the basis of Vue framework, ElementUI component library, JavaScript, HTML, CSS and other technologies. The back-end of system was deployed on Oracle database by using Java language, Spring MVC framework and MyBatis framework. The HTTPS protocol and security isolation gateway hardware were used to ensure the security of data transmission and interaction. The functions of equipment arrival registration, uploading and review of acceptance materials, reminding and tracking the implementation of regular maintenance were realized. Results After the launch of the system, the data review time was reduced from (31.05±6.28) d to (6.62±4.57) d, the acceptance completion time was shortened from (44.30±7.35) d to (13.42±6.34) d, the agreed time arrival rate was increased from 67.78% to 97.78%, the acceptance data integrity rate was increased from 60.00% to 91.11%, and all the differences were statistically significant (P<0.05) Conclusion The online acceptance system for medical equipment based on Oracle database can standardize the work functions of suppliers and engineers in the acceptance process of medical equipment, ensure the integrity and traceability of acceptance materials, which can improve the efficiency of acceptance work.
Objective To evaluate the clinical effect of different drug-coated balloon (DCB) in percutaneous coronary drug balloon angioplasty, and to provide data reference for selection, procurement and clinical selection, and ultimately benefit patients. Methods The clinical data and 1-year follow-up data of hospitalized patients undergoing percutaneous coronary drug balloon angioplasty in a grade Ⅲ-A hospital from January 2021 to November 2022 were retrospectively analyzed. Patients were divided into 4 groups according to DCB brand: control group (using SeQuent Please DCB), product A group, product B group, and product C group. The main outcome indicators [target lesion revascularization (TLR) within 12 months] and secondary outcome indicators (30 d unplanned readmission rate, rescue stent implantation rate, abnormal myocardial enzymes rate) of the patients in 4 groups were compared. Results A total of 693 patients were included, including 142 in the control group, 170 in the product A group, 250 in the product B group, and 131 in the product C group. Compared with the control group, product A (OR=3.43, 95%CI: 1.39 to 8.45, P=0.007), product B (OR=2.45, 95%CI: 1.01 to 5.91, P=0.047), product C (OR=2.88, 95%CI: 1.12 to 7.37, P=0.028) had statistically significant effects on TLR within 12 months. Compared with the control group, product A (OR=10.71, 95%CI: 1.32 to 87.20, P=0.027) had a statistically significant effect on the 30 d unplanned readmission rate. Compared with the control group, the three products had no statistical significance on the rescue stent implantation rate and abnormal myocardial enzymes rate (P>0.05). Conclusion Products A, B, C may increase the incidence of TLR in patients within 12 months. Product A may increase the 30 d unplanned readmission rate of patients. The Results of this study support the mainstream view that DCB has no class effect, and emphasize the importance of head-to-head comparisons of different DCB throughout the life cycle to better ensure patient safety and treatment outcomes.
Objective To study the impact of input data selection accuracy of the M/M/C model in queuing theory on the accuracy of predicting the reasonable allocation quantity of monitors under centralized management mode. Methods A total of eleven wards were selected as research subjects, and the duration of medical orders was extracted as the actual usage time of the monitor. The comparison groups were set up according to the combined calculation of 11 wards (group 1), the combined calculation of medicine and surgery respectively (group 2), and the independent calculation of each ward (group 3), and the prediction model of M/M/C model in queuing theory was established. Combined with the nursing requirements and the waiting time curve of the queuing system, the prediction interval of the number of monitors configured was deduced, and the difference between the prediction interval and the actual number of monitors configured under three conditions was compared respectively. Results The group 1 model predicted the largest difference (maximum difference was 7.84, minimum difference was 2.45), the group 2 model predicted the next largest difference (maximum difference was 6.73, minimum difference was 2.27), and the group 3 model predicted the smallest difference (only 4 wards with differences of 1 or 3). The difference between the three groups was statistically significant (H=20.768, P<0.001), the difference between the group 3 model and the group 1 and 2 model was statistically significant (P<0.001) ,and the difference between the group 1 and 2 model was not statistically significant (P=0.465). Conclusion The selection accuracy of input data has a certain impact on the prediction accuracy of the M/M/C model in queuing theory. When calculating the number of allocation using the queuing theory model, medical institutions should improve the accuracy of data selection as far as possible, select input data according to the smallest ward unit, and adjust the actual number of allocation based on the prediction Results and the actual clinical situation to improve the rationality of the number of allocation.
Objective To improve the use efficiency of hospital procurement funds, enhance the economic value, social benefits and academic influence of hospital large-scale equipment allocation, reduce hospital operating costs and patient burden, achieve lean management of medical equipment procurement access, and promote the high-quality development of hospitals. Methods The ideas and Methods of equipment procurement access evaluation were analyzed from four perspectives: clinic, medical engineering, finance and expert, and digital subtraction angiography (DSA) equipment was taken as an example to construct a three-level evaluation index system for equipment procurement access based on health economics. Effective Methods such as field investigation, quantitative index ranking, matter-element model analysis, comprehensive evaluation score and polynomial regression model were adopted to carry out quantitative comprehensive analysis of evaluation index. Results A three-level evaluation index system of DSA equipment procurement access based on clinical perspective, medical engineering perspective, financial perspective and expert perspective was formed. Based on the construction and analysis of the evaluation system of health economics, it found the starting point and direction for the access management of large medical equipment purchase in hospitals. Conclusion This study provides a set of effective evaluation ideas, algorithms and Methods for large-scale equipment procurement access, which can provide some references for public hospitals to standardize and do a good job in large-scale medical equipment procurement access management.
Objective To optimize the procurement process of medical equipment in public hospitals based on information technology, and improve the refinement and standardization of procurement management. Methods By combing through the equipment procurement management process, the application strategy of information technology in medical equipment procurement management was proposed, the information system of medical equipment procurement was built, and the specific application of information technology in each link of the hospital procurement process was expounded. A total of 50 procurement projects were selected before and after the system application, respectively. Then their procurement cycle, procurement process accuracy and supplier quality rate were compared to verify the effectiveness of the system application. Results After the implementation of lean management based on the medical equipment procurement information system, the procurement cycle was shortened from (67.50±7.71) d to (39.50±14.58) d, the procurement process accuracy rate increased from 70.00% to 92.00%, and the supplier quality rate increased from 68.00% to 92.00%. And all differences were statistically significant (P<0.05). Conclusion The exploration and construction of medical equipment procurement information system is an important technical support to promote the standardization of hospital procurement management, which is of great significance for optimizing procurement process management and improving hospital operation efficiency.
Objective To discuss the development trend of new quality productivity in the field by analyzing the patent information in the field of intelligent health and medical care and measuring the technological innovation ability in the field. Methods The intelligent health and medical care patents from the establishment of the database to December 31, 2023 were obtained from the Patent Search and Analysis system of China National Intellectual Property Administration, and the basic information such as the time trend of the number of patent applications, the distribution of applicant types and regional layout were statistically analyzed. The co-occurrence network and BERTopic theme clustering method were used to deeply analyze the technological themes of patents and their evolutionary trends. Results The number of patent applications in the field of intelligent health and medical care in China increased exponentially, from the first patent application in 1988 to the cumulative application of 12217 patents in 2023. It could be divided into four periods: budding exploration period (1988-2010), steady growth period (2011-2015), rapid rise period (2016-2020) and innovative prosperity period (2021-). The regions and types of the first applicants differed significantly. The key technologies were mainly concentrated in G16H (healthcare informatics) and A61B (diagnostics; department of surgery; identification) field. The common topics included artificial intelligence systems, AI recognition, storage media, machine learning, recommendation models, cardiovascular diseases and mental disorders, and CT image processing. In terms of technological evolution, A61B always occupied an important position in the entire development process, from budding exploration period, steady growth period, rapid rise period to innovative prosperity period, the relevant patent topics continued to expand in breadth and depth, from the early focus of clinical practice application, and gradually penetrated into many fields such as health management, disease prevention, rehabilitation and nursing. Conclusion The new quality productivity in the field of health and medical care represented by artificial intelligence is gradually taking shape and accelerating its development. In the future, the development of the intelligent health and medical industry can be comprehensively promoted from multiple dimensions such as policy orientation, scientific research investment, and talent reserve to achieve further innovation and upgrading of productivity in the health and medical field.
Objective To explore the research status and development trend of telemedicine in clinical application in China. Methods Relevant literatures in CNKI, Wanfang and VIP databases were searched, and the characteristics, research topics and hot topics of the literatures were visually analyzed by VOSviewer V1.6.18. Results Domestic research started late, the number of published papers was on the rise, the distribution of journals was relatively scattered, there was no high-level core author cluster, and the cooperation relationship between institutions was not close. The clinical applications of telemedicine were mainly electrocardiogram monitoring, fetal heart monitoring, chronic disease management and intelligent diagnosis and treatment, and were gradually moving towards wisdom. Research hotspots in this field included remote surgery, remote ultrasound, remote rehabilitation and assisted diagnosis, etc. Remote consultation, cardiovascular disease, chronic disease rehabilitation and high-risk pregnancy were application focuses in this field. Conclusion The support of the new generation of information technology has enriched the clinical application of telemedicine, innovated the medical service model, and provided a new direction for research and development. Telemedicine integrates 5G, Internet of Things and artificial intelligence, which has great potential to serve clinical practice.
Objective To investigate the changes in functional connectivity of EEG signals in patients with cerebellar infarction and their relationship with cognitive function. Methods EEG data from 37 cerebellar infarction patients (cerebellar infarction group) and 40 healthy controls (control group) were preprocessed and decomposed into five frequency bands: delta (1-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), and gamma (30-45 Hz). Through phase synchronization analysis, the phase locking value was calculated to construct the electrode lead connectivity matrices and compute network attribute parameters, including small-world index, clustering coefficient, local efficiency, global efficiency, shortest path length, and to evaluate the relationships between these network attribute parameters and cognitive function scores. Results The cerebellar infarction group showed significantly increased functional connectivity in the delta and gamma bands (P<0.05) and significantly decreased connectivity in the alpha and beta bands (P<0.05). In the delta band, cerebellar infarction group exhibited significantly increased global efficiency, local efficiency, and clustering coefficient (P<0.05), with considerably decreased small-world index and shortest path length (P<0.05). In the alpha and beta bands, cerebellar infarction group showed significantly reduced global efficiency, local efficiency, and clustering coefficient (P<0.05), with a significantly increased shortest path length (P<0.05) .In the gamma band, the local efficiency and clustering coefficient in cerebellar infarction group were significantly higher than those in the control group (P<0.05). Global efficiency, local efficiency, and clustering coefficient were positively correlated with cognitive function scores (P<0.01), while the shortest path length was negatively correlated with cognitive function scores in the cerebellar infarction group (P<0.01). Conclusion Abnormal resting-state brain network connectivity and network attributes in patients with cerebellar infarction are closely related to cognitive dysfunction, providing a basis for exploring more effective diagnostic and therapeutic strategies.
Objective To evaluate the effect of deep learning iterative reconstruction (DLIR) algorithm on the quality and noise of chest CT images. Methods The original data of 60 cases of chest CT examination in our hospital were retrospectively selected, and filtered back projection reconstruction (group A), adaptive statistical iterative reconstruction-veo 40% (group B), DLIR-medium (group C) and DLIR-high (group D). The CT values and SD values of lung tissue, aorta, muscle, thoracic vertebrae, and air were measured in four groups, and the signal to noise ratio (SNR) and contrast to noise ratio (CNR) of each tissue were calculated. Two physicians used a double-blind method to subjectively score image noise, artifacts, diagnostic confidence, and overall image quality on a 5-point scale. Results There was no significant difference in the CT values of lung tissue, aorta, muscle, thoracic spine and air between the four groups (P>0.05), but there was a statistically significant difference in noise values (P<0.05) and different reconstruction algorithms had a significant impact on the image noise. There were statistically significant differences in SNR and CNR among the four groups (P<0.05), among which the SNR and CNR of group D were the highest, and those of group A were the lowest. The subjective scores of the two physicians were in good agreement, and the Kappa value ranged from 0.781 to 0.884. There were significant differences in image noise, artifacts, diagnostic confidence, and overall image quality scores among the four groups(P<0.05), the subjective scores of groups C and D were higher than those of groups A and B, and there was no difference in subjective scores between groups C and D (P>0.05). Conclusion The DLIR algorithm can reduce the noise of chest CT images, provide higher image quality, enhance doctors’ confidence in diagnosis, and has great potential to reduce radiation dose.
Propofol is the most frequently used intravenous anesthetic in clinical practice and is extensively applied in medical environments such as operating rooms and intensive care units. However, both over-administration and under-administration of propofol can induce perioperative and long-term adverse effects. Thus, it is of great significance to possess direct, non-invasive, and reliable methods for monitoring the blood concentration of propofol. Different from other intravenous anesthetics, propofol has an extremely high vapor pressure. This high vapor pressure enables its detection in exhaled breath, and the concentration of propofol in exhaled breath can mirror its blood concentration, rendering non-invasive monitoring of propofol blood levels feasible. This paper reviewed the research progress of various exhaled-breath propofol monitoring technologies, summarized the existing problems of these technologies, and forecasted the future research directions and development trends, with the aim of providing references for the rational clinical application of propofol, enhancing the safety of anesthesia, and optimizing the relevant monitoring technologies.
The electroacupuncture apparatus is a type of medical device that treats diseases by applying electricity to the tail end of the filiform needle, superimposing the effects of acupuncture and electrical stimulation. It has the advantages of continuously adjustable parameters, strong excitability, and good clinical repeatability, and is widely used in clinical practice. With the continuous innovation of modern technology, there has been continuous exploration of the principle parameters of electroacupuncture apparatuses and the development of new types of electroacupuncture apparatuses. The degree of intelligence of electroacupuncture apparatuses has been continuously improved, playing an important role in the treatment of various pain syndromes, neurodegenerative and functional diseases, etc. This paper focused on the principles, parameters, and types of electroacupuncture apparatuses, sorted out and studied the relevant articles and patents in the past five years. By comparing and analyzing the characteristics of various existing electroacupuncture apparatuses, it summarized the laws, considers innovation, aiming to provide a reference for the research and development of electroacupuncture apparatuses.
Parkinson’s disease (PD) is a progressive neurodegenerative disorder mainly manifested by motor symptoms, and it can also be accompanied by various non-motor symptoms. Approximately 33%-46% of PD patients are comorbid with rapid eye movement sleep behavior disorder (RBD). RBD is one of the key prodromal symptoms of PD, and its early occurrence provides an opportunity for the early diagnosis and early treatment of PD. Compared with the research based on brain structure using conventional MRI sequences, resting-state functional MRI (rs-fMRI) explores the neuropathological mechanisms of patients with PD complicated by RBD (PD RBD) from the perspective of brain functional networks, and searches for imaging targets for its diagnosis and treatment. In this way, it can improve the quality of life of patients, delay the progression of the disease, and reduce treatment costs. This article summarized the application progress of various analysis methods of rs-fMRI in PD RBD, with the hope of providing a reference for the precise diagnosis and treatment of PD RBD and promoting the overall improvement of the diagnosis and treatment level of PD RBD.
Testicular torsion, that is, the torsion of the spermatic cord and its contents, is an emergency in the urinary system, and early evaluation is helpful for timely intervention to prevent testicular necrosis. Conventional ultrasound (US) is the first choice for the diagnosis and evaluation of testicular diseases. Although US has a high diagnostic value for testicular torsion, it has certain limitations. With the development and widespread clinical application of new ultrasound technologies, such as the emergence of contrast-enhanced ultrasound, shear wave elastography, and super microvascular imaging technology, these have compensated for the limitations of US in the diagnosis of testicular torsion. This paper mainly introduced the application progress of these new ultrasound technologies in the diagnosis of testicular torsion, and analyzed and compared the advantages and disadvantages of different technologies, with the aim of providing clinicians with more diversified and accurate technical references in the diagnosis of testicular torsion.
Hepatocellular carcinoma (HCC) is a common malignant tumor that poses a huge threat to human health. Microvascular invasion (MVI) is an important cause of postoperative recurrence and metastasis in HCC patients. Currently, the diagnosis of MVI is mainly confirmed through postoperative pathological examination, which, however, is an invasive method. Non-invasive prediction of MVI before surgery is beneficial for guiding individualized treatment and improving prognosis. In recent years, researchers have achieved remarkable results in predicting MVI in HCC using radiomics and Deep learning (DL) methods. The application of these methods has significantly improved the accuracy of predicting MVI in HCC, providing more precise guidance for patients’ treatment. This article elaborated on the research achievements in predicting MVI in HCC based on radiomics and DL in recent years, with the expectation of providing a reference for the clinical realization of precise non-invasive prediction methods, facilitating the formulation of individualized treatment plans, improving patients’ prognosis, and promoting the development of diagnostic and treatment technologies for liver cancer.
Objective To analyze the operation and fault maintenance records of Varian EDGE linear accelerator in a hospital from 2017 to 2023, explore the fault characteristics and rules of this kind of accelerator, in order to improve the maintenance efficiency of equipment and reduce the downtime in subsequent use, and provide reference for the use and maintenance management of similar equipment. Methods According to the hardware and software system of Varian Truebeam platform, the technical manual attached with Varian and the internal software system block diagram of the device, combined with the system fault code ID and hardware structure, this study tried to propose a fault classification method of the system module, and the faults were divided into: (Ⅰ) STN (Stand Node Subsystem) module faults; (Ⅱ) BGM (Beam Generation and Monitoring Subsystem) module faults; (Ⅲ) COLL (Collimation Subsystem) module faults; (Ⅳ) XI (X-Ray image Subsystem) faults; (Ⅴ) PU (Positioning Unit System Subsystem) faults. (Ⅵ) COUCH (Couch Subsystem) faults; (Ⅶ) SAFETY related module faults; (Ⅷ) COLLING related module faults; (Ⅸ) WS (WorkStation&Software) related faults. Through statistical analysis of the fault data, the fault type, occurrence frequency, maintenance strategy and preventive measures were summarized. Results The fault distribution had time regularity and the failure rate was higher in the start-up stage.There was a positive correlation between the failure rate and the equipment load when the quarterly load was 4000-12000 person-time. COLL faults account for the highest proportion, especially Multi-Leaf Collimator (MLC) related faults. In addition, mechanical wear and electrical failures were the main causes of component replacement. Conclusion Varian EDGE linear accelerator is a mature accelerator with stable performance output and the highest failure rate during startup. Class III COLL system has the highest proportion of faults, and MLC faults are more in this kind of faults, which should be paid attention to when maintaining. Mechanical wear and electrical failure are the main reasons for the need to replace parts of the equipment, and the status of key components must be checked regularly. Conventional spare parts, such as blade motors and blade nuts, should be reserved on site to improve equipment maintenance efficiency.
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